• Journal of Periodontal and Implant Science
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• v.53 no.4
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• pp.306-317
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• 2023

Purpose: Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 60% β-TCP and 40% HA compared to demineralized bovine bone mineral (DBBM). Methods: This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ² test. Results: Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. Conclusions: The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM.

• Journal of Life Science
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• v.20 no.8
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• pp.1207-1213
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• 2010

The purpose of this study was to evaluate the effect of porcine cancellous bone as a scaffold in a rat calvarial defect model. Critical-sized defects were created in 30 male Sprague-Dawley rats. The animals were divided into critical defect (CD, n=10), $\beta$-tricalcium phosphate (TCP) graft (BT, n=10) and porcine cancellous bone graft (PCB, n=10) groups. Each defect was filled with $\beta$-TCP mixed with fibrin glue or porcine cancellous bone powder mixed with fibrin glue. In the CD group, the defect was left empty. All rats were sacrificed at 8 weeks after bone graft surgery, and bone formation was evaluated by gross observation, plain radiography, micro-computed tomography scanning and histological evaluation. Repair of bone defect was the least in the CD group, and significant new bone formation was observed in the PCB group. Grafting of porcine cancellous bone was more efficient for regenerating new bone than grafting $\beta$-TCP.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.466-472
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• 2010

Introduction: This study examined the effect of recombinant human bone morphogenetic protein (rhBMP)-2 and $\beta$-tricalcium phosphate ($\beta$-TCP) on new bone formation in a rabbit calvarium using a rapid prototype titanium cap (RP Ti cap). Materials and Methods: Eight New Zealand white rabbits were used in this study. Hemispherical RP Ti caps (10 mm in diameter) were implanted subperiosteally on the rabbit calvaria. $\beta$-TCP was filled in the RP Ti cap in the control group, and rhBMP-2 soaked $\beta$-TCP was used in experimental group. The rabbits were sacrificed 2 and 4 weeks after the operation. The volume and pattern of newly formed bone was analyzed by micro computed tomography (CT). Results: Macroscopically, there were no abnormal findings in any of the animals. The micro CT images revealed new bone from the calvaria that expanded gradually toward the top of the titanium cap, particularly along the inner surface of the titanium cap in the experimental group at 4 weeks after grafting. There was no significant difference in new bone volume ratio between the control and experimental groups at 2 weeks after grafting. There was a statistically significant difference in the new bone volume ratio between the experimental ($14.1{\pm}1.8\;%$) and control ($7.2{\pm}1.5\;%$) groups at 4 weeks after grafting (P<0.01). Conclusion: The RP Ti cap can effectively guide new bone formation and rhBMP-2 can induce the new bone formation.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.435-445
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• 2000

The purpose of this study was to compare the leakage of four different obturation techniques in conjunction with immediate apical barrier of ${\beta}$-tricalcium phosphate(TCP) in teeth with open apex. Eighty single-rooted human premolar teeth were prepared and sectioned horizontally, so maximum diameter in apex was 4mm. Apical defects that were similar to open apex, were created with #1/2 round bur and SF104R bur. The apical foramen were opened to a size 80 file extended 3mm beyond the apex. The teeth were placed into the oasis block soaked saline to simulate periapical tissue often associated with pulpless teeth and received apical barriers consisting of TCP followed by obturation using lateral condensation technique, vertical condensation technique, continuous wave technique and thermoplasticized gutta-percha injection technique. Two unobturated teeth served as positive and negative controls. Teeth were immersed in resorcinol-formaldehyde resin for S days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5mm(level 1), 2.5mm(level 2) and 3.5mm(level 3) from the apex, and examined under a stereomicroscope at ${\times}40$ magnification. The photographs were taken at ${\times}40$ magnification of the filling in each level and scanned. The leakage length in tooth/resin interface was measured at each of the three levels. Each ratio of leakage was obtained by calculating the ratio of the leakage length of canal wall infiltrated with resin to the total length of the canal and was analyzed statistically(One-way ANOVA and Scheffe test). The result were as follows : 1. At the level 1, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), and the most leakage in the continuous wave technique group(group 3). There was statistically significant difference between the thermoplasticized gutta-percha injection technique group and the continuous wave technique group(p<0.05). 3. At the level 3, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there were no statistically significant differences between other groups(p>0.05). These results suggest that thermoplasticized gutta-percha injection technique which had 1mm apical gutta-percha matrix after the formation of TCP apical barrier, can demonstrate favorable apical sealing.

• International Journal of Oral Biology
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• v.30 no.3
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• pp.99-103
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• 2005

Bone morphogenetic proteins (BMPs), members of a large group of TGF-beta family, are important molecular regulators of morphogenesis of numerous tissues and organs, including bones and teeth. Most BMPs are capable of inducing bone formation in vivo and therefore are of considerable clinical interest for regenerating mineralized tissues. Recently, we have developed a method to culture cells from human cementum (human cementum-derived cells, HCDCs). HCDCs, when attached to synthetic hydroxyapatite/tricalcium phosphate (HA/TCP) ceramic and transplanted into immunodeficient mice, formed histologically identifiable cementum-like tissue. Since it is unclear to what extent BMPs are involved in cementogenesis, the aim of this study was to establish which BMPs are expressed by cementogenic HCDCs and whether the expression of BMPs is related to the degree of cellular differentiation in vitro. HCDCs were maintained in growth medium (DMEM/F12 supplemented with 10% FBS) until confluent (proliferation stage). Upon reaching confluence, cells were incubated in the differentiation medium (DMEM/F12 medium containing 10% FBS and 50 mg/ml ascorbic acid) for 14 days (differentiation stage). Next, HCDCs were incubated in mineralization medium (DMEM/F12, 50 mg/ml ascorbic acid, 2.5 mg/ml of ITS (insulin-transferrinselenium), 5 mM beta-glycerophosphate and $10^{-8}M$ dexamethasone) for another 14 days (mineralization stage). At the end of each differentiation stage, total RNA was isolated and evaluated for BMPs (2 through 8) expression by employing real time RT-PCR. HCDCs expressed most of BMPs examined except BMP-7 and BMP-8. Furthermore, on average, the highest levels of BMPs were expressed at the earlier differentiation stage, prior to the initiation of mineralization in vitro. These results indicate that several BMPs are expressed during cementoblastic differentiation and suggest that BMPs may be involved in the homeostasis of human cementum.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.535-563
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• 1993

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Proceedings of the Materials Research Society of Korea Conference
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• 2009.11a
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• pp.41.1-41.1
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• 2009

Aerosol Deposition (AD) is anovel way to fabricate bioactive ceramic coatings in biomedical implants and prostheses applications. In the present work, silicon-substituted hydroxyapatite (HA) coatings on commercially pure titanium were prepared by aerosol deposition using Si-HA powders. The incorporation of silicon in the HA lattice is known to improve the bioactivity of the HA, makingsilicon-substitute HA an attractive alternative to pure HA in biomedical applications. Si-HA powders with the chemical formula $Ca_{10}(PO_4)_6-x(SiO_4)x(OH)_2-x$, having silicon contents up to x=0.5 (1.4 wt%), were synthesized by solid-state reaction of $Ca_2P_2O_7$, $CaCO_3$, and $SiO_2$. The Si-HA powders were characterized by X-ray diffraction (XRD), X-ray fluorescence spectrometry (XRF), and Fourier transform infrared spectroscopy(FT-IR). The corresponding coatings were also analyzed by XRD, scanning electron microscopy (SEM), and electron probe microanalyzer (EPMA). The results revealed that a single-phase Si-HA was obtained without any secondary phases such as $\alpha$- or $\beta$-tricalcium phosphate (TCP) for both the powders and the coatings.The Si-HA coating was about $5\;{\mu}m$ thick, had a densemicrostructure with no cracks or pores. In addition, the proliferation and alkaline phosphatase (ALP) activity of MC3T3-E1 preosteoblast cells grown on the Si-HA coatings were significantly higher than those on the bare Ti and pure HA coating. These results revealed the stimulatory effects induced by siliconsubstitution on the cellular response to the HA coating.

• Korean Journal of Materials Research
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• v.14 no.12
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• pp.893-899
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• 2004

Even though Ti-6Al-4V has gained popularity as an implant material, the possible dissolution of Al and V ions in body fluids remains a matter of concern. Though commercially pure Ti (Cp-Ti) overcomes this problem, the mechanical strength of pure titanium remains very low. Thus, in this experiment Cp-Ti was processed by Equal channel angular processing (ECAP), in order to increase the mechanical strength. The biocompatibility of ECAP-Ti, Cp-Ti and Ti-6Al-4V was examined by the apatite formation on each sample surface, after treating the surface with 5M NaOH and soaking in Simulated body fluids (SBF). Initially, the samples were mechanically polished on silicone carbide paper (#2000). The polished samples were treated with 5M NaOH solution at $60^{\circ}C$ for 24 hours. The NaOH treated samples were washed gently with distill water and dried at $40^{\circ}C$ for 1 day. The dried samples were heat treated in air at $600^{\circ}C$ for 1 hour. The surface morphology of these samples were studied using SEM and XRD. The SEM studies showed network of pores in all samples. The XRD showed oxide layer formation on Cp-Ti and Ti-6Al-4V. samples. However the oxide layer in ECAP-Ti was not substantial. These samples were immersed in SBF, kept at $36.5^{\circ}C$ for seven days period. At the end of 7 days, the apatite formation was confirmed only on Cp-Ti and was not observed in Ti-6Al-4V and ECAP-Ti. These observations of apatite formation relate to the fact that Cp-Ti showed greater oxide layer than other samples. The apatite examined was confirmed as tricalcium phosphate (TCP) using EDS and XRD.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.119-128
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• 2009

Purpose: The aim of this study was to evaluate the stemness of cells from canine dental tissues and bone marrow. Methods: Canine periodontal ligament stem cells (PDLSC), alveolar bone stem cells (ABSC) and bone marrow stem cells(BMSC) were isolated and cultured. Cell differentiations (osteogenic, adipogenic and chondrogenic) and surface antigens (CD146, STRO-1, CD44, CD90, CD45, CD34) were evaluated in vitro. The cells were transplanted into the subcutaneous space of nude mice to assess capacity for ectopic bone formation at 8 weeks after implantation. Results: PDLSC, ABSC and BMSC differentiated into osteoblasts, adipocytes and chondrocytes under defined condition. The cells expressed the mesenchymal stem cell markers differently. When transplanted into athymic nude mice, these three kinds of cells with hydroxyapatite /${\beta}$- tricalcium phosphate (HA/TCP) carrier showed ectopic bone formation. Conclusions: This study demonstrated that canine dental stem cells have stemness like bone marrow stem cells. Transplantation of these cells might be used as a therapeutic approach for dental stem cell-mediated periodontal tissue regeneration.